Lois J. Loescher, Ph.D., R.N., is a junior investigator involved in cancer genetic risk research at the Arizona Cancer Center (AZCC). A 5-year K07 award will prepare her as an independent investigator to conduct theory-based, behavioral clinical trials with the ultimate goal to decrease cancer incidence/mortality in individuals and families at genetic risk for cancer. Dr. Loescher's previous training in nursing and clinical genetics and her postdoctoral training in psychometric analysis support her ability to move forward from descriptive theory testing to behavioral intervention clinical trials models. The formal training she now needs will target health behavior theories, intrafamily communications theories/models, multi-method analytic approaches (qualitative and quantitative), and will enable her to conduct behavioral trials within cancer-prone families. Dr. Loescher's training will occur at the University of Arizona and several U.S. locations. The AZCC is an NCI-designated comprehensive cancer center with an international reputation for cancer prevention research. Dr. Loescher's sponsors are David S. Alberts, M.D. (AZCC) and Nell D. Weinstein, Ph.D. (Rutgers University) who will mentor her in skin cancer prevention research/clinical trials development and risk perception/communication research, respectively. Additional collaborations with other faculty experts in the targeted training areas provide the intellectual foundation for the K07 experience. Dr. Loescher's research plan focuses on melanoma-prone families and builds on current research programs at the AZCC. No published studies address specific risk processes (defined as perceived risk, intrafamily risk communications, health-care-provider originated risk communications, and risk control actions) in melanoma-prone families. Phase 1 seeks to describe, analyze, and interpret family members' risk processes; and develop a multidimensional instrument to measure of melanoma risk communications. Phase 1 will use rigorously coded qualitative interview data to elicit information about domains of risk communications that can be incorporated into the proposed instrument and used for future behavioral models. Specific aims of Phase 2 are to assess the psychometric properties of measures of melanoma risk processes (defined above) and a related construct, cancer worry. Additionally the relationships of risk process variables and cancer worry will be evaluated in at least 240 patients with melanoma or dysplastic nevi and their first-degree relatives (FDRs). Phase 2 will evaluate differences in risk control behaviors between melanoma/DN patients and FDRs. Results of this research will be used to formulate a model of risk processes and develop future behavioral interventions to reduce cancer risk.